title: White matter lesions in children and adolescents with migraine.
abstract: BACKGROUND
  The etiology and clinical importance of white matter lesions in migraine remain poorly understood. To understand these issues more fully, we reviewed the brain magnetic resonance imaging scans of pediatric patients and assessed the relationships between white matter lesions, migraine type, patent foramen ovale, and right-to-left shunting.
  
  
  METHODS
  The magnetic resonance imaging scans of a cohort of children (n = 89) and adolescents, ages 6 to 18 years, who participated in a study of migraine and patent foramen ovale were reviewed. All children in the cohort had undergone saline contrast transthoracic echocardiography and transcranial Doppler studies.
  
  
  RESULTS
  White matter lesions were detected in 15 of the 89 patients (17%). White matter lesions were small (<5 mm) in the majority (10/15; 66%). We observed no relationship between the presence of white matter lesions and (1) migraine type (six patients with white matter lesions among 35 with migraine with aura [17%] vs. nine with white matter lesions among 54 without aura [17%]; P = 1.0); (2) patent foramen ovale (five with white matter lesions among 35 with patent foramen ovale [14%] vs. 10 with white matter lesions among 54 without patent foramen ovale [19%]; P = 0.77); or (3) shunt size (two large shunts in 15 with white matter lesions [13%] vs. nine large shunts among 72 without white matter lesions [13%]; P = 1.0).
  
  
  CONCLUSIONS
  These results indicate that small white matter lesions are not infrequent in children and adolescents with migraine. However, no relationships between white matter lesions and migraine type, patent foramen ovale, or degree of right-to-left shunting were observed.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Primary Children's Medical Center and the University of Utah, Salt Lake City, Utah; Division of Pediatric Neurology, Department of Neurology, Primary Children's Medical Center and the University of Utah, Salt Lake City, Utah. Electronic address: Meghan.Candee@hsc.utah.edu.
authors.forename: Meghan S
authors.initials: MS
authors.lastname: Candee
authors.forename: Rachel T
authors.initials: RT
authors.lastname: McCandless
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Moore
authors.forename: Cammon B
authors.initials: CB
authors.lastname: Arrington
authors.forename: L LuAnn
authors.initials: LL
authors.lastname: Minich
authors.forename: James F
authors.initials: JF
authors.lastname: Bale
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology*; D002648:Child; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056784:Leukoencephalopathies / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008881:Migraine Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D017585:Ultrasonography, Doppler, Transcranial
keywords: MRI; headache; migraine; patent foramen ovale (PFO); white matter lesions